Gynecological Oncology

Laparoscopic nerve-sparing oncological surgery

Classic surgery for cervical cancer often leads to bladder and bowel complications and other problems caused by nerve damage. Surgery assisted by laparoscopy reduces these risks. The outstanding performance of modern laparoscopic cameras makes it possible to identify and function test the pelvic nerves in order to ensure that their function is maintained postoperatively. With the help of these minuscule cameras, the nerves and all important structures become visible through multiple visual enhancement.   

This development has paved the way for a new, much gentler treatment method: the parasympathetic nerve-saving laparoscopic radical vaginal hysterectomy type 3 - or more simply, the " Possover Method ". Prof. Possover is one of the few doctors qualified for this method. He has performed over 3000 laparoscopic procedures and more than 900 nerve-sparing laparoscopic surgeries to treat cervical cancer.

The operation lasts about two to three hours with a hospital stay of two to five days, depending on the management of pain and the general condition of the patient.

Preservation of fertility in cervical cancer

If cervical cancer is treated at an early stage of the disease the so-called radical vaginal trachelectomy can preserve the ability to give birth. In this procedure, the cervix and the surrounding tissue are removed vaginally, while the lymph nodes are removed laparoscopically. Since the uterus remains intact, a later pregnancy is possible. However, in women who give birth after a trachelectomy, the birth must be performed by caesarean section.

This operation also takes about two to three hours with a hospital stay of two to five days, depending on the management of pain and the general condition of the patient.

Surgery for uterine cancer using laparoscopy

Laparoscopic surgery for uterine cancer involves the removal of the uterus (hysterectomy) and ovaries as well as the pelvic and abdominal lymph nodes using a minimally invasive surgical technique. If the cervix is involved, surgery is performed according to the "Possover Method".

This procedure and the "Possover Method" last about two to three hours with a hospital stay of two to five days, depending on pain management and the general condition of the patient.

Management of advanced gynecological cancer

Patients with advanced cervical carcinoma - i.e. a tumour larger than 4 cm - and lymph node involvement are treated with a combination of radio- and chemotherapy.

For this type of disease, surgical removal of lymph nodes using laparoscopy is recommended as the basis for optimal treatment planning. Various factors, such as a possible involvement of the pelvic lymph nodes or the spread of the tumour (metastases) to the surrounding tissue and/or blood vessels, have a decisive effect on the survival of the cancer patient. These factors can be very reliably clarified by laparoscopy. After receiving the final histology results, the gynaecologist can decide together with the patient on the further course of treatment. Since laparoscopic surgery is not a major open procedure, radio- and/or chemotherapy can be started much earlier than after open surgery.

Furthermore, laparoscopy reduces the risk of postoperative adhesions (fibrous ligaments that adhere to tissues and organs) and wound healing disorders. In addition, the patient can be actively involved in the decision-making process. A hospital stay of one night is normally sufficient for laparoscopic staging surgery.